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Disseminated cutaneous rhinosporidiosis: a polymorphic presentation in an immunocompetent patient.

Sahu B, Sahu P, Puhan MR - Indian J Dermatol (2015 Mar-Apr)

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and Venereal Diseases, Shrirama Chandra Bhanj Medical College, Cuttack, Odisha, India. E-mail: drbharati123@gmail.com.

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There was a history of nasal mass with recurrent epistaxis 6 months back, excised but without any record... Four common varieties have been described nasal, ocular, cutaneous, and disseminated forms... Cutaneous lesions are very rare, and generally associated with simultaneous or with past history of mucosal lesions... Three main types of cutaneous rhinosporidiosis and their mode of spread had been reported: Satellite skin lesions surrounding mucosal lesions through autoinoculation... Disseminated skin lesions with or without the nasal involvement through a hematogenous route... Oral dapsone might arrest the maturation of the sporangia and cause stromal fibrosis... Our patient had disseminated cutaneous rhinosporidiosis without any evidence of immunosuppression... She had polymorphic lesions, an asymptomatic subcutaneous giant mass, and a smaller painful pyogenic granuloma like lesion... Only two cases of polymorphic lesions in a single patient had been described earlier... This case is being reported due to rare polymorphic lesions of rhinosporidiosis in an immunocompetent patient.

No MeSH data available.


Two lumps over left antero-lateral thigh
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Figure 1: Two lumps over left antero-lateral thigh

Mentions: A 65-year-old female presented with asymptomatic lumps, two in number on her left antero-lateral thigh of 10 months duration. On examination the larger nodule was of size 16 × 12 cm with a smooth surface, firm to soft in consistency and with dilated veins over it. It was not attached to underlying structures, with minimal signs of inflammation. The smaller nodule (5 × 5 cm) was highly tender, soft in consistency giving a pyogenic granuloma-like appearance at the site of rupture Figure 1. There was a history of nasal mass with recurrent epistaxis 6 months back, excised but without any record. The patient used to take bath in pond daily. General physical and systemic examinations were within normal limits. Routine hemogram was within normal limits. Chest X-ray and abdominal ultrasonography were within normal limits. ELISA for HIV was non-reactive. Radiological evaluation revealed a clearly delineated dense radiopaque subcutaneous mass not attached to underlying structures. A biopsy from the lesion showed immature and mature thick-walled sporangia with endospores in highly vascular sub-epithelial stroma and dermis, respectively Figure 2. Few sporangia rupturing to release the endospores were also seen Figure 3.


Disseminated cutaneous rhinosporidiosis: a polymorphic presentation in an immunocompetent patient.

Sahu B, Sahu P, Puhan MR - Indian J Dermatol (2015 Mar-Apr)

Two lumps over left antero-lateral thigh
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4372969&req=5

Figure 1: Two lumps over left antero-lateral thigh
Mentions: A 65-year-old female presented with asymptomatic lumps, two in number on her left antero-lateral thigh of 10 months duration. On examination the larger nodule was of size 16 × 12 cm with a smooth surface, firm to soft in consistency and with dilated veins over it. It was not attached to underlying structures, with minimal signs of inflammation. The smaller nodule (5 × 5 cm) was highly tender, soft in consistency giving a pyogenic granuloma-like appearance at the site of rupture Figure 1. There was a history of nasal mass with recurrent epistaxis 6 months back, excised but without any record. The patient used to take bath in pond daily. General physical and systemic examinations were within normal limits. Routine hemogram was within normal limits. Chest X-ray and abdominal ultrasonography were within normal limits. ELISA for HIV was non-reactive. Radiological evaluation revealed a clearly delineated dense radiopaque subcutaneous mass not attached to underlying structures. A biopsy from the lesion showed immature and mature thick-walled sporangia with endospores in highly vascular sub-epithelial stroma and dermis, respectively Figure 2. Few sporangia rupturing to release the endospores were also seen Figure 3.

View Article: PubMed Central - PubMed

Affiliation: Department of Skin and Venereal Diseases, Shrirama Chandra Bhanj Medical College, Cuttack, Odisha, India. E-mail: drbharati123@gmail.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

There was a history of nasal mass with recurrent epistaxis 6 months back, excised but without any record... Four common varieties have been described nasal, ocular, cutaneous, and disseminated forms... Cutaneous lesions are very rare, and generally associated with simultaneous or with past history of mucosal lesions... Three main types of cutaneous rhinosporidiosis and their mode of spread had been reported: Satellite skin lesions surrounding mucosal lesions through autoinoculation... Disseminated skin lesions with or without the nasal involvement through a hematogenous route... Oral dapsone might arrest the maturation of the sporangia and cause stromal fibrosis... Our patient had disseminated cutaneous rhinosporidiosis without any evidence of immunosuppression... She had polymorphic lesions, an asymptomatic subcutaneous giant mass, and a smaller painful pyogenic granuloma like lesion... Only two cases of polymorphic lesions in a single patient had been described earlier... This case is being reported due to rare polymorphic lesions of rhinosporidiosis in an immunocompetent patient.

No MeSH data available.